88-376 WHITE - CITY CLERK
PINK - FINANCE G I TY OF SA I NT PAU L Council p�'i���
CANARY - DEPARTMENT
BLUE - MAVOR File NO. a —
ounci solution 3�
Presented By �'��
Referred To Committee: Date
Out of Committee By Date
RESOLVED: That Application (I.D. 17748) for the renewal of a State Class C
Gambling License applie for by Guadalupe Youth Council at 408
Main Street be and the ame is hereby approved./d��d.
COUNCIL MEMBERS
Yeas Nays r%�' Requested by Department of:
Dimond �
�ng In Favor
Goswitz
Rettman
� � Against BY
��
�lson ��Q
� } 5 1�0t� Form Appr d by City Attorn
Adopted by Council: Date
Certified Ya��My� uncil S ta gY
sy �"��
e, °;
�1ppro by Mavor: Dat c: �i��� � �� Approve b Mayor for ubmission to Council
By
PU�IISNED ��i�� 2 � 1 88
.���y�,,=d��-7�
��F: c��a�. �,� , �►,�� �RE�N ��f�E1' No. 0 Q0 9 8 8
�� _ ��� ��,���,
�1CT8� �Z '�f.�C . � �a�os�er►�s o�cron �cm c�wc
. . No. � —' euooer o� ..�.. C�043t�C3.1 REE�a�CY1
Fir�ar� & .�t. 29&-5Q56 or+o�n T��„o� _
�al appl.i�ati.c� for a State of ` Class C C�a.�i.tab�.e G�nbli,r� L�.c�nse.
NOTI'�'IL�TTON DATEs ' 2/29/88 �
_ �A710N�;(MProve(Al ot Rej�t(R)) C01Nl�N. RlPOIIT: ; ;
. ... PIAM�M10 OOM�YBOION CWIL SEAVICE COMM�8SION � �DATE W � DA7E OUI' ANALYS7 � � � . PHqiE NO.. �
__ . mNHlO ODwMYC$pN .. .1SD 02b�8CFpOL BOARD . � � � �. ���1 � . . . . � � . � _ � -
� - .STAFF � . qiARTEFt W�4SSION � AS 13 � ADDL INFO.ADDED* � AET'D TO CONTII�T . COI�ITUElR-� �
. . . .. _ . � � _ROR ADOL NiO. . _FE�B�pC M0�* .
.� DI67#ICi COUNCIL � - * . � . . -
� : BIIPPGH4'f$�MRtlCN COIMiCIL O&IECTIVE7� . . � . . .. � .�. � . . .. . . . . � . .
' M�Ial��l�lr INI�y C�/01111NMTY�(YVhO.VY�.WfKn�VVllere.VNyr): ,
Ms. Marie Sriy�lex, on betlalf of the C�.iadal 'Y�zth Council, reque�ts (:o�ncil ap�rc�al of
tY�ir re�aa]. agpla.cati.c� for a State af ' ` Charitable Gambli� �.vex�e: A, Cla�s "�"
lioense;is for Singo <�l.y. The sessioa�s hP1d � �'hursday aft.e�oort� betw�ri �e haurs -
c� 1.30 p.m. and 5z 30 p.m. at 408 Main S. t. P.roct�ds c� to heip �t�pdrt the t�al�e
C,Ynirch ar�d School.
�+cn,�oK�e«�s,�aw�aq.�.�.«r�s):
All �+equired applicatio¢�s arid fees ha.�re suhtd.tted. Tf Cbuncil � is grant+ed,
the C�iac3alupe.Youth Ooauycil, which k�as� is e�.isten�ce ftar 32 y�ears, wfi..11 be allcxued tr�o
oontinue their spo�risorship.
COlIf�11B11�(WM.1Mrn:and To Whom►: � ° '
If C�nicil �pprat�al is not giv�en, ttye lu�e Yauth Caur�cil will be fo��oed t,o clisc�ztinue
thei.r sporssarship,
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/iLTERqA11Vl�: GY7pi.
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lIIBTOR�lP1�iT8:
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LiOAL IBSIIE&
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_ T�IVISION OF LICENSE AND P�;RMIT ADMINI TRATION DATE �!� g �o� / �~°��� �
INTERDF.PARTMF.NTAL REVIEW CHECKLIST Appn Processed/Received by
Lic Enf Aud
Applicaut ,�QI"i�i JY1�� Home Address a � �i� E� `Ctr'�CAfCI{�r•
Rus ine s s Name �Q I k�} p�l'1Ci�dme Phone 1�1� p 7�0�
Business Address , `�{� �Q l h s Type of License(s)
Business Phone ""' �-�,� CLa� � C�a�,b�i.�q�)1✓13�•
Public Hearing Date 3 �S �6 License I.D. 4� t�7 �3
at 9:00 a.m. in the Council Chambers,
3rd floor City Hall and Courthouse State Tax I.D. 4� N �4
llate Notice nt; ✓ Dealer 4� (�,� ��}
to Applicant _��`� � $�
Federal Fi.rearms �� n/��
Public Hearing
DATE INSPE TION
REVIEW VERFIED (CO UTER) CUMMENTS
A roved No A roved
Bldg I & D �
N�A'
Health Divn. '
I��p' (
�
Fire Dept. �
N�'4 I
Police Dept.
� S�' I31�� �
License Divn. �
�
City Attorney O L(,,� �
i
Date Received:
Site Plan � ��- �,/
To Council Research 3�Z' 6 b
Ig� or Letter � �J Date
f rom Landlord � �$ �
�
����7�
, ,— Charitable Gambling Control Board � For eoard Use Only
. Rm N-475 Griggs-Midway Bldg.
1821 University Ave. Paid Amt:
- ` St. Paul, MN 551043383 Check No.
:.....:�' (612) 642-0555 Date:
- GAMBLING LIC NSE RENEWAL APPLlCATION
UCENSE NUMBER: �t)d8iio-0O1 /EFF. D E: � USiOi/81 /AMOUNT OF FEE: 91fl�_QO -
1.Applicant—Legal Name of Organization 2.Street Address '
G'�N�iGi i� u"iSADAIIiPE YOLITfi C�Ii ST � 4�8 Main Streetei
3. Ciry,State,Zip 4.Couny 5.Business Phone
5t Paui. �1 551G2 R�p9eY 6i2 224-f707
6. Name of Chief Executive Officer 7. Business Phone
Fr 3 hackern�w�i l er -
8. Na e of Treasurer or Person Who Accounts for Revenues � �:: . � 9. Business Phone
' }(_ )'ll.e, �,5_:. '� `
yS=7- G '1 �Y
10. Name of Gambling Manager 11. Bond Number 12. BusiAess Phone
- hfarie �nvder �s45765 �? — � L
13. Name of Establishment Where Gambling Will Take Place 14.County 15. No.of Active Members
Narth Star �31da St aaul Aa�r 32
16. Lessor Name 17. Monthly Rent: � GC1�e�(l
North Star Bl�n r�ssc 30 �t,�jl� :
18. If Bingo will be conducted with this license, please specify days and times of Bingo.
- Days Times Da Times Days Times
t /.' -5.'30
19. Has license ever been: ❑ Revoked Date: ❑ Suspended Date: ❑ Denied Date:
20. Have intemal controls been submitted previously7 �Yes 0 No(If"No,"attach copy)
21.Has current lease been filed with the board? `�Yes ❑ No(If"No>"attach copy)
_ 22.,H�current sketch been filed with the board�.._ . .i .. Yes . ,.,Q,No(If"Na�°,attaCh cppY) ;,,,.....__ ..:_ __, __.:-.;,- :�:�y. -
..�..-
�. _. -.._ _ . . . .
_. _ -... .
.
GAMBLIN SITE AUTHORIZATION
��By my signature below,local Iaw enforcement officers or agents of t e Board are hereby authorized to enter upon the site,at any time,gambling is.-� .
being conducted,to observe the gambling and to enforce the law fo any unauthorized game or practice. °�:
BANK REC RDS AUTHORIZATION •
� By my signature below,the Board is hereby authorized to inspect th bank records of the General Gambling Bank Account whenever necessary to .
fulfill requirements of current gambling rules and law.
OATH
I hereby declare that:
1. 1 have read this application and all information submitted to the 8 ard;
2. All information submitted is true,accurate and comptete;
3. All other required information has been fully disclosed;
4. I am the chief executive officer of the organization;
5. I assume full responsibility for the fair and lawful operation of all tivities to be conducted;
6. I will familiarize myself with the laws of the State of Minnesota res ecting gambling and rules of the board and agree, if licensed,to ebide by those
laws and rules, including amendments thereto.
'�� 23.Official Legal Name of Organization Signature(Chief ecutive Officer) Date Title
• � ��/�,p•) ���jLS�/W�/
" u�'U. E.' U C h . ir t ' ,
: A� � ACKNO EDGEMENT OF OTICE�Y LOCAL GOVERNING BODY
I hereby acknowledge receipt of a copy of this ap�ation. By ackno edging receipt,I admit having been served with notice that this application will
be reviewed by the Charitable Gambling Control Board and if approv by the Board,will become effective 30 days from the date of receipt(noted
below), unless a resolution of the local governing body is passed whi specifically disallows such activity and a copy of that resolution is received by
the Charitable Gambling Control Board within 30 days of the below n ed date.
24.C�t�y/Counry Name(Local Goveraing Body) Township: If site is located within a township, please complete items 24
L �'� �� C-�- "v j. -1-%� .,i � and 25:
Signature of Person Receiving Application: 25�Signature of Person Receiving Application
�, • • �,i C�-�' ( L ,
Title Date Received'(this date begin$30 day period) Title:
�. c, . . _ ,t-.. ;!- ��� �,'�
Name of Person Delivering Application to Local Governing Body: Township Name
1' �t.� � ...=�Yt�c%i t.('�J��,,�
CG-00022-01 (5/8� � hite Copy—Board Canary—Applicant Pink—Local Governing Body
City of Saint Paui (/� �_ �/S�'
� Depa�tment of inance and Management Services � �
. � •Lice se and Permit Division � ��
203 City Hall
• St. Pa 1, Minnesota 55102-298-5056
; APPLI AT10N FOR UCENSE
� CASH CHECK CLASS NO. New Aenew
� a u �- a a �
t.
Date � /�O 19' °
� Code No. Title of License From �` r � / 19 6�To °` �f� 19�
' � �� T _""°�'i.,�'r" 1_� �r :c �_. • , v? i� i� � • �
,� �� r, .�.; 1� �� �,1��:�., 1 . ��, ` ,
? � ���in, < ? APPticanUCompany Nart�e / .
100
. ..,.
i ^T.: ;1_ � ' �� , ., F i.-
� 100 Business Nams
� ��'�.... �� � -- r r �
1� �.,;s 1 � C,t , !. i � J �' '�,,,r
� Business Addrosa Phon�Na
! 100
I 100 Mail to Address Phons Na
� 100 .��`,� Ct � � �'', LJ Y'1 :.w Crs'/'� � �i L ?.
ManapenOwner•Nams '
I ��
i •�
� .::... >-f ti ','.. � t. �, , �:t:�"t 1 � •
100 hlanaqer/Gwnsr•Flome Addrosa PAo�e No.
j 4098 Application Fee
Z. 50 .•�
i Received the Sum of T 100 =�� �^c; ;� i : f� ;l �� !C ''
� �., ��•.� � Manaqxl0w�er•City,Slate 6 Dp Cada �
100 T tal 100
� y�
L1 �?
��e�se��Spe�to. ��. e . � �..:� r�...�.� -� .: �.,�,.�� ,�
Y• Signaturo of Appiicant
i .
Bond•
! _ Company Name Policy No. Expiration Date
i �flSUf8f1C@'
l Company Name Policy No. Expiration Date
Minnesota State Identification No. Social Security No.
� Vehicle information:
Serial Number ate Number
Other.
THIS IS A RE �1PT FOR APPLICATiON
THIS iS NOT A LICENSE TO OPERATE Your application for lic nse will either be granted or rejected subiec!to the provisfons of the zoning
� ordinanca and completfon ot the inspections by the Health, Fi e,Zoning andlor Llcense Inspectoro.
� 52 rl�. ►1.C'��-�I Cc�'��0►''
� $15.00 CHARGE FO ALL RETURNED CHECKS � �'�� ����h�'t.u�'��r
� 53o A�h d►�e.c,J
e;u 1 �l
'' � —�c� �U.r 1� 5 n�c�v�
��F`� ��
�� � o� �a�����C�j
�,O la'�,'G�
..a,,�J�..�,A� - a.s-SE'l�,re.,
` City of Saint Paul � r,2�y�j
' Department oE Fin nce and Management Services `��
.�► ' Division of LYce se and Permit Registration
INFORMATION RE UIRED WITH APPLICATION FO PERMIT TO CONDUCT CHAR.ITABLE GAMBLING GAME IN
SAINT PAUL
1. Full and complete name of organizat 'on which is applying for license
2. Address where games will be held �� Q
Number Streec City Zip
3. Name of manager signing this applica ion who will conduct, operate and manage
Gambling Games o� Date of Birth /�f z,
—7-
(a) Length of time manager has been ember ot applicanc organization _� ,2 �JQ�vt,d_
4. Address of Manager � �� Gz.c,cr2 �S/ O
Yumber S eec , City Zip
5. Day, dates, and hours this applicatio is ior G�L�b� �.� /,•3G–S.',?ur'�Nt ��
6. Is the applicant or organization orga ized under the laws o= the State ot �IId? �
7. Date of incorporation i9
8. Date when registered with the State o Kinnesoca j �frf]
9. How long has organization been in e:ci tance? 3�, �o..ov�
10. How long has organization been in existence in St. Paul? �� �Ea.i.d..
11. What is the purpose of the organizatio ? �'p fj��� g,�,,�n�� �.2 C'�,��✓
)
12. Officers of applicant organization
Name Name �
Address S3Q �j��,.,, Address ��o �S �Q�yN� 4�
Title ��,Q�� DOB Tit?e /� �q�1 DOB �,
�
Name � Name ��� �.�y ,phJ
Address �ddress /Zpp g
Title �/ji DOB i Title DOB yO �
T
13. Give names of officers, or any other pe sons who paid for services to tne organi�ation.
Name vame (,��
Address �ddress
Title Ti�1e
(Attach separate sn e� '^.r acd'=_or.s_ ::a�as. �.
�.
14. Attached hereto is a list of names and addresses of all members oE the organizacio.l. :
�S
15. In whose custody will organization's records be kept? `
Name Address � �
T--_ L
16. Persons who will be conducting, assisting in conductfng, or operating the games:
Name ��� �,��t„�Q,�,�/ Date of Birth %Y�y�� �
i
Address �'c.�c.� ,� � ��„� � � �Q Q� f'�,y,�
Name of Spouse �,(f�J Date of Birth
Dates when such person will conduct, assist, or opezate
� �.�J .s,r�.�/
Name ��.�,,,_� Date of Birth 9 jZ �
_,��
Address !6 �� � ��,,,,�
Name of Spouse �,�,, ,�ij�,e��,,,/ Date of Birth ��y�/�_
Dates when such person wil? conduct, ass:st, or operate
i/`
17. Have you read and do ;rou thor�ughly unde:stand the provisions of all laws, ordinances,
and regulatior.s gove�ing the operat:on ot Charitable Gambiing g�mes? ,/�(�
---r
18. Attached hereto on t�e for� Fnrnished by the City o� St. Paul fs a Financial Report
which itemizes a1.1 receipts, e:speases, and d�sbursemencs oi the applicant organization
as well as aii organ:zat'ons who have :ecei��ed `unds =or che orecediag calendar year
which has beez signed, prepared, and verified by ��� �
vame
� �� 3 � �°ct a�-�-� �'Lwc� �L l�'a.�.�.e��.�.�,.u� s-s'1 o q
�adress
who is the ,�,� of the applicant Organization.
Yame oc Of�i.ce
19. Operator of premises where �ames �ail+ be held:
Name
�
B�rsiness Address �U fj ,�'��^,� ,�
Home Address �_ �� 1�It,�=''`�,,`/
20. Amount of rent paid by applicsnc Organi�ation Eor rezc oz che ha11; specify amount
paid per 4-hour seGsion �/p��a p
. , �-��7�
ti. �
� 21. '�he proceeds oi the games will be d sbursed after deducting prize layout costs and
operating expenses for the followin purposes and uses:
U
22. Has the premises where the games ar to be held been certified for occupancy by the
City of Saint Pau1? ;2QJ
23. Has your organization riled tederal form 990—T? _L�o If answer is yes, please attach
a copy with this appiicacion. IF a swer is no, e:cplain why:
_ �.
Any changes desired by the app?=canc �ssa iat'on may be made only with the consent of the
City C�uncil.
•
rganization
Date By; ��� �
T� Manager in char e of game
C � n E 3 2 v� rr r+. n .. C C� v1
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� �=�Y oE Sa1nt Paul
ti Departmenc f Finance and Management Ser•fices � (�i—�7�
, Divislon oE Gicense and Permie Adminisc;acion 4 o
a�
' UNIFORH CH ITABLE GAMBLINC FINANCIAL REPORT
Date
1. Name of Organizacion �
2. Addresa vhera Charicabie Cambi ng is coeducted f�p � �'y(�,' ��
3. Report for period covering 19� through � / Z 8 �9�
4. Total number oE days played �Q
5. Croaa receipca Eor abave perio ; _� �� �' � O
6. Crosa prize payoucs Eor above eriod ; �' � g�, ��
7. Net receipts - line 5 minus li e 6 ; � 9'1,� �,,. n d
8. Expenses incurred in conducting and operating gaae:
A. Crosa vages paid. Atcach rker list vith
namee, addresa and groas wa es. ; �
H. Renc for '�a veeks � _ _,��SD� O
C. License fee ; �O . o �
D. Insurance • � �
E. Bond i / 4 C�. � �
F. Dishonored chacks noc recov� ed ; � �g� � �
C. Employers F.I.C.A. _ �
x. salea Tax ; /. 9 '73. QO
I. Hinn. U.C. Tax = �
J. Federal U.C. Tax �
K. Hiscellaneous Expensea. Ida tify tha aaount
and to vhom paid.
1. i �C22� ��'6
2. �!-Ctl�� S �v O. 7 0
3. ��a-�. � �9. d .
4. s����
9. Tocal Exps�sea T�� ; �1 p / �• �D
/, d
10. Nec Incoma - line 7 minus line 9 $ � � c�� �� � �
,,
11. Checkbook bslanee beginning of per od s Z, �m � � � 11
12. Total of lina 10 and 11 S �� "f� a o��� oG
a
13. Toca2 contributiona fros line t7 S !/, 9 0�.,3 . p Q
�
14. Cheekbook balanc� end of reportieg period -
line 12 leae line l3 s ?;'� a (, O d
15. Specify use made of awount on line 13:
i
c:oMPt.rrE TtiC itEVERSE STt)e
:5: �`:�ure.^..eacs :_o� a=ounc ia :iae 12:
Name �'"� a. m1[Ln .wr...�lid � ' Name ' •
Address �3 C7 �ix�� �,./ �,(� Address •
Dace Rec'd �.� u,/ �,Z1�_ Dace Rec'd � �
Purpoae �.�,ah,,�/� �-/�. ���,,,�1,_/ Purposa
Signacure �- Signacure
of Recipienc of Recipienc
Amounc 3
Amount
Name N�e
Address Addresa
Dace R�c'd Date Rec'd
Purposa Purpoaa
Signacure Signacure -
of Reclpian[ of R�clpient \�+
• Amount _ Amount
Name Name
Address Addresa
Da�e Rec'd __ _ r � Datn Rec'd r �
Purpoaa Purpoae
Signacur� Signature
oE Recipient oE Recipient
� Amounc Amount
Nams Name
Address Address -
Date Ree'd � Date Rec'd ��
� Purpose Purpose
Sigracure Signacure
of Recipient of Recipient
Asount
Ameunt
17. Total Diaburseaencs
THIS AEPaRT MIST BE FILLED•IN COl�LE?ELY TO QUALIFY APPLICATION FOR CHARITABLE GAIiBLINC
LICEHSE. .
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s *«=,a, CITY OF SAINT PAUL
. :° � 'y DEPA TMENT OF FINANCE AND MANAGEMENT SERVICES
: '�� e� DIVISION OF LICENSE AND PERMIT ADMINISTRATION
°� ,... � Room 203. Ciry Hall
Saint Paul,Minnesota 55102
George Latimer
M+ayor
Februarq 29, 1988
Marie Snqder (Guadalupe You h Council)
2443 E. Larpenteur
St. Paul, MN 55109
Dear Ms. Snyder:
Your application for a Stat Charitable Gambling License has been
received in this office.
A hearing on your applicati n for Class C. Gambling License ID �(s)
17748 will be held before t e St. Paul City Council. on March 15, 1988 at
��._ 9:00 A.M. , Third Floor of t e City and County Court House. This date
may be changed without the icense & Permit Division`s consent aad/or
lmowledge. Therefore, it i suggested that you call the Citp Clerk`s
Office at 298-4231 to confi this hearing date.
You are hereby notified tha yaur attendance is required at this
meeting. Failure to appear ma.y result in denial of your application.
Very ruly yours
f s, �''�'•� ..� .� �' .
�:� �,'�• -. -�. . ., .� �-�-'��..�
- �•; -��..,-
J '�eph F� Carchedi
Licease Inspector
JFC/lk
�-��7�
,��==a, • CITY OF SAINT PAUL
'� �' ' DEPA MENT OF FINANCE AND MANAGEMENT SERVICES
a � �
: �� �
�: � DIVISION OF LICENSE AND PERMIT ADMINISTRATION
,,.. Room 203, City Hall
Saint Paul,Minnesota 55102
George latimer
Mayor
3/1/88
To: Virginia Baisley
From: Christine Rozek �.
Re: Record Check
In connection with an application for renewal of a State Class C Gambling
License at 408 Main Street, a rec rd check is requested on the following:
Marie L. Snyder Barbara Svendsen
2443 E. Larpenteur Avenue 12008 Jefferson
St, Paul
Birthdate: 12/22/16 Birthdate:. 9/24/33
Diane Meyer J. Hackenmueller
12008 Jefferson 530 Andrew Street
St. Paul
Birthdate: 4/20/48 Birthdate:
A copy of the application is atta hed.
CR/car
attachment